NM LF 4004-1 (rev. //1) UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW MEXICO In re: Case No. Debtor. CERTIFICATION IN SUPPORT OF ENTRY OF CHAPTER 13 DISCHARGE The Debtor(s), , hereby certify(ies): 1.I have made all of the payments required under the confirmed Chapter 13 Plan in this case(including any modifications) and I have fully complied with the terms of that Plan. 2.I have completed an instructional course concerning personal financial managementdescribed in 11 U.S.C. 247 111 and have filed Official Form 423 either prior to the filing ofthis certification or with this certification. 3.Check the box that applies; one box MUST be checked:[ ] I am not required by judicial or administrative order or law to pay a domesticsupport obligation (child support or spousal support). [ ] I was required to pay a domestic support obligation during this case, and I certifythat I have paid all domestic support obligations due through today, under the order or lawrequiring support payments. If I have paid domestic support obligations during this chapter 13 case, my current employer222s name and address are: Name of current employer Employer222s address: 4.I have not received a discharge in any prior Chapter 7, 11, or 12 bankruptcy case filedwithin the four-year period prior to the date that I filed this Chapter 13 bankruptcy case;and I have not received a discharge in any previous Chapter 13 bankruptcy case filed duringthe two-year period before I filed this Chapter 13 bankruptcy case. 5.I have no reason to believe that there is any pending investigation or proceeding in whichI may be found guilty of, nor do I owe a debt arising from, any of the following: American LegalNet, Inc. www.FormsWorkFlow.com NM LF 4004-1 (rev. //1) (i)a felony involving the abuse of bankruptcy law;(ii)any violation of federal or state securities law;(iii)fraud, deceit, or manipulation in a fiduciary capacity (where I amresponsible for managing someone else222s money, property or affairs)involving the purchase or sale of any securities;(iv)any civil offense under 247 1964 of Title 18 U.S. Code (federal criminal laws);or(v)any criminal act, any intentional tort, or willful or reckless misconduct thatcaused serious physical injury or death to another individual in thepreceding 5 years. I certify under penalty of perjury that the information provided in these certifications is true and correct to the best of my knowledge and belief. Date: Debtor222s Signature Name: Address: Telephone: Email: Date: Debtor222s Signature Name: Address: Telephone: Email: ATTORNEY CERTIFICATION I represent the above captioned Debtor(s) and hereby certify that I have explained to the Debtor(s) the averments set forth above, and to the best of my knowledge and belief, each Debtor identified above is in compliance with the provisions of 11 U.S.C. 247247 521, 1308, and 1328(a), and meets the eligibility requirements for a chapter 13 discharge pursuant to 11 U.S.C. 247247 1328(g)(1) and 1328(h). Date: Attorney Signature Name: Address: Telephone: Email: American LegalNet, Inc. www.FormsWorkFlow.com